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Organization Information
Name of contact person
Organization
Email
Phone
Address
Is your organization located in or does it serve a rural community or population?
Yes
No
What topic are you seeking training/education funds for?
Racial and ethnic minorities
Rural health
LGBTQ+
Disability
People 65+
Religious minorities
Low socioeconomic status
Who will provide the training/education?
How many staff from your organization with receive the training/education?
Estimated cost of training/education?
Around what date would the training/education take place?
Please provide a paragraph describing the scope of the training including a detailed description of the contents and how it will positively impact your work.
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